A heart healthy diet consists of plenty of fruits and vegetables, whole grains, limited saturated fats, and low salt intake. Eating too much salt in combination with excessive fluid intake can increase blood pressure, causing the heart to work harder. It is important to monitor the foods that you consume and be conscious of your heart health.
Please refer to the information and links below to gain a better understanding of healthy dietary strategies during heart failure. Specifically, the DASH diet and the Mediterranean diet can both promote a healthy lifestyle under these conditions. There are also some excellent resources for maintaining a heart healthy lifestyle.
An important change for anyone with heart failure can be adding more fiber to the diet. Whole grains are a good way to add more fiber to the diet. Fiber from these sources help lower blood cholesterol. This in turn may help decrease risk of heart failure. Another advantage of fiber is the feeling of fullness it gives. If you feel fuller, you are less likely to over-eat or snack between meals, which can help with weight reduction. Whole grains are also a great source of many vitamins and minerals that promote healthy living.
When looking for products high in fiber it is important to read food labels and the ingredients. Look for foods that list whole wheat, graham flour, oatmeal, whole oats, brown rice, wild rice, whole-grain corn, popcorn, whole-grain barley, whole-wheat bulgur, and whole rye. In order to ensure that a product is whole wheat, and thus high in fiber, whole wheat must be listed as the FIRST ingredient (unlike the label pictured above, which contains "wheat flour"). This is an easy step to take before purchasing a food product. It is also important to understand the amount of fiber in each product. To find this information, simply read the label (see image above). It is recommended that people consume 20-35 g of fiber per day.
Another notable difference is determining between soluble fibers and insoluble fibers. Both have positive results. Soluble fiber can help lower LDL or "bad" cholesterol and insoluble fiber may help slow the progression of heart disease. Examples of soluble fibers is shown in the image below.
Those who have experienced heart failure should reduce the amount of sodium intake to prevent edema, fatigue, and stress on the renal system. Recommendations for the elderly, heart failure patients, and patients on large doses of Lasix (Furosemide) differ. The table below describes those differences. Though it is important for patients with heart failure to adhere to a low sodium diet, it is often difficult for many patients. Reasons for this poor adherence include lack of knowledge or education, inadequate or poor food choices, and interference with social eating habits.
Population
Sodium Restriction (AI)
Healthy Elderly (over 71 years old)
1200 mg/day
People with Heart Failure
1200-2400 mg/day
Patients on Large Dose of Lasix
<2000 mg/day
Sources of Sodium
Sodium in the diet can come from supplemental salt, salt or sodium added in the processing of foods, chemically softened water, or inherent sodium in foods. Examples of high sodium foods are smoked, processed, or cured meats and fish, tomato juices, salted snacks, canned soup, frozen entrees, cheeses, packaged mixes, and many more. About 20% of sodium in the diet can come from salt added to food during preparation and at the table, and as much as 80% can come from processed foods.
Alternatives to Sodium
To avoid excessive salt use, it can be helpful to remove salt shakers from the dinner table and avoid adding salt when cooking. Since decreasing sodium intake might leave you craving more flavor from the foods you eat, try experimenting with different herbs and spices. Examples of low sodium herbs include; thyme, basil, oregano, rosemary, and paprika. Trying a variety of different recipes and vegetables with naturally fuller flavors can also help fill the salt void.
When adding different herbs and spices, be aware of the content of your spice cabinet. Seasonings (combinations of spices/herbs commonly sold together) may contain high salt content without any obvious indicators. Use seasonings with caution, being aware of sodium content in the mixture.
Tips to Reduce Sodium Intake
Here are some tips to lower your salt and sodium intake:
Look for foods that are labeled “low-sodium,” “sodium-free,” “no salt added,” or “unsalted.” Check the total sodium content on food labels. Be especially careful of canned, packaged, and frozen foods. A nutritionist can teach you how to understand these labels.
Don’t cook with salt or add salt to what you are eating. Try pepper, garlic, lemon, or other spices for flavor instead. Be careful of packaged spice blends as these often contain salt or salt products (like monosodium glutamate, MSG).
Avoid processed meats (particularly cured meats, bacon, hot dogs, sausage, bologna, ham, and salami).
Avoid foods that are naturally high in sodium, like anchovies, salted nuts, olives, pickles, sauerkraut, soy and Worcestershire sauces, tomato and other vegetable juices, and cheese.
Take care when eating out. Stick to steamed, grilled, baked, boiled, and broiled foods with no added salt, sauce, or cheese.
Use oil and vinegar, rather than bottled dressings, on salads.
The DASH (Dietary Approaches to Stop Hypertension) Diet may help to lower blood pressure. It includes eating low-fat or non-fat dairy products, low salt, fruits and vegetables, whole grains and a limited consumption of saturated fats and trans-unsaturated fats found in such things as red meats and oils. DASH also uses foods high in calcium, potassium, and magnesium, which lower blood pressure when combined together. While the DASH diet does place an emphasis on reducing sodium, all adults should limit pre-packaged and pre-prepared foods, which many times are high in sodium. The DASH diet is an eating style that can be recommended for everyone.
The Mediterranean Diet, much like the DASH diet, recommends a diet high in fruits and vegetables, low in sodium, and with moderate consumption of red meats and saturated fats. The Mediterranean Diet allows the consumption of olive oil, which contains "healthy" fats that have been proven to improve cholesterol levels. The following websites will direct you to information regarding the Mediterranean Diet.
Lifestyle Changes Following recommendations can help to alleviate symptoms, slow the progression of heart failure and improve everyday life. People with mild to moderate heart failure have the ability to lead normal lives as a result of diet, exercise and other healthful habits.
As with any diet program, exercise is a crucial aspect of making healthy lifestyle changes. Traditionally, bed rest was recommended for individuals with CHF to avoid straining an already weak heart. However, in the past two decades, numerous studies have shown advantages from endurance exercise. The benefits of such studies appear to be the result of peripheral adaptations. One study in particular studied the effects of endurance exercise on morbidity and mortality associated with CHF- results demonstrated that an endurance training program lasting 14 weeks decreased hospitalizations 71% and deaths 68%.
Example of CHF Exercise Programming:
Mode
Goals
Intensity/Frequency/Duration
Time to Goal
Aerobic: Large Muscle Activities
Increase ventilatory capacity Increase peak work rate and endurance capacity
4-7 days/week 20-60 min/session or 2-3 sessions/day of 10-20 minutes 40-70% VO2max (i.e. brisk walking 4 mph to jogging 6 mph)
3 months
Resistance: Circuit Training
Reduce atrophy
High reps, low resistance
3 months
Flexibility: Upper and Lower body range of motion ROM activities
Maintain ROM, reduce stiffness
2-3 days/week
4-6 months
Functional: Activity-Specific Exercise
Improve ADLs Return to work Improve quality of life and maintain independence
2-3 days/week
3 months
Warm-up and Cool down: Need to be gradual and prolonged - 10 to 15 minutes at least
Brubaker, Peter H. & Myers, Jonathan N. "Chronic Heart Failure." Exercise Management for Persons With Chronic Diseasesand Disabilities. 3rd ed; Champaign,IL: American College of Sports Medicine, 2009. 92-96. (look also: HumanKinetics.com)
Note: Highly skilled personal trainers or physical therapists should be monitoring CHF patients and checking vitals at all times, from start to finish.
Recipes As mentioned previously, food preparation is an effective way to implement dietary changes. The following recipes provide meal options for common dishes to facilitate the implementation of heart healthy diet modifications.
Why Does A Heart Healthy Diet Matter?
© Brown
A heart healthy diet consists of plenty of fruits and vegetables, whole grains, limited saturated fats, and low salt intake. Eating too much salt in combination with excessive fluid intake can increase blood pressure, causing the heart to work harder. It is important to monitor the foods that you consume and be conscious of your heart health.
Please refer to the information and links below to gain a better understanding of healthy dietary strategies during heart failure. Specifically, the DASH diet and the Mediterranean diet can both promote a healthy lifestyle under these conditions. There are also some excellent resources for maintaining a heart healthy lifestyle.
General Information on Heart Healthy Diets
Healthy Diet Goals-American Heart Association
Heart Failure Nutrition Guidelines-Cleveland Clinic
Adding Fiber to Your Diet
An important change for anyone with heart failure can be adding more fiber to the diet. Whole grains are a good way to add more fiber to the diet. Fiber from these sources help lower blood cholesterol. This in turn may help decrease risk of heart failure. Another advantage of fiber is the feeling of fullness it gives. If you feel fuller, you are less likely to over-eat or snack between meals, which can help with weight reduction. Whole grains are also a great source of many vitamins and minerals that promote healthy living.
When looking for products high in fiber it is important to read food labels and the ingredients. Look for foods that list whole wheat, graham flour, oatmeal, whole oats, brown rice, wild rice, whole-grain corn, popcorn, whole-grain barley, whole-wheat bulgur, and whole rye. In order to ensure that a product is whole wheat, and thus high in fiber, whole wheat must be listed as the FIRST ingredient (unlike the label pictured above, which contains "wheat flour"). This is an easy step to take before purchasing a food product. It is also important to understand the amount of fiber in each product. To find this information, simply read the label (see image above). It is recommended that people consume 20-35 g of fiber per day.
Another notable difference is determining between soluble fibers and insoluble fibers. Both have positive results. Soluble fiber can help lower LDL or "bad" cholesterol and insoluble fiber may help slow the progression of heart disease. Examples of soluble fibers is shown in the image below.
More Fiber Links:
Whole Grains and Fiber-American Heart Association
The Nutrition Source: Fiber
Dietary fiber: Essential for a healthy diet
Sodium Restriction and Heart Failure
Those who have experienced heart failure should reduce the amount of sodium intake to prevent edema, fatigue, and stress on the renal system. Recommendations for the elderly, heart failure patients, and patients on large doses of Lasix (Furosemide) differ. The table below describes those differences. Though it is important for patients with heart failure to adhere to a low sodium diet, it is often difficult for many patients. Reasons for this poor adherence include lack of knowledge or education, inadequate or poor food choices, and interference with social eating habits.
Sources of Sodium
Sodium in the diet can come from supplemental salt, salt or sodium added in the processing of foods, chemically softened water, or inherent sodium in foods. Examples of high sodium foods are smoked, processed, or cured meats and fish, tomato juices, salted snacks, canned soup, frozen entrees, cheeses, packaged mixes, and many more. About 20% of sodium in the diet can come from salt added to food during preparation and at the table, and as much as 80% can come from processed foods.Alternatives to Sodium
To avoid excessive salt use, it can be helpful to remove salt shakers from the dinner table and avoid adding salt when cooking. Since decreasing sodium intake might leave you craving more flavor from the foods you eat, try experimenting with different herbs and spices. Examples of low sodium herbs include; thyme, basil, oregano, rosemary, and paprika. Trying a variety of different recipes and vegetables with naturally fuller flavors can also help fill the salt void.When adding different herbs and spices, be aware of the content of your spice cabinet. Seasonings (combinations of spices/herbs commonly sold together) may contain high salt content without any obvious indicators. Use seasonings with caution, being aware of sodium content in the mixture.
Tips to Reduce Sodium Intake
Here are some tips to lower your salt and sodium intake:More Sodium Links:
Low-Sodium Guidelines for Heart Failure-Cleveland Clinic
Low Sodium Diet for Heart Failure Patients-Indiana University Health
How to Follow a Low-Sodium Diet-Heart Failure Society for America
Diet and Congestive Heart Failure University of California San Francisco
The DASH Diet
The DASH (Dietary Approaches to Stop Hypertension) Diet may help to lower blood pressure. It includes eating low-fat or non-fat dairy products, low salt, fruits and vegetables, whole grains and a limited consumption of saturated fats and trans-unsaturated fats found in such things as red meats and oils. DASH also uses foods high in calcium, potassium, and magnesium, which lower blood pressure when combined together. While the DASH diet does place an emphasis on reducing sodium, all adults should limit pre-packaged and pre-prepared foods, which many times are high in sodium. The DASH diet is an eating style that can be recommended for everyone.
(Bellevue College-Science Division)
More DASH Diet Links:
Your Guide to DASH-National Heart, Lung, and Blood Institute
DASH diet: Healthy eating to lower your blood pressure-MayoClinic
Sample menus for the DASH eating plan-MayoClinic
DASH diet: Tips for dining out-MayoClinic
DASH diet: Tips for shopping and cooking
The Mediterranean Diet
The Mediterranean Diet, much like the DASH diet, recommends a diet high in fruits and vegetables, low in sodium, and with moderate consumption of red meats and saturated fats. The Mediterranean Diet allows the consumption of olive oil, which contains "healthy" fats that have been proven to improve cholesterol levels. The following websites will direct you to information regarding the Mediterranean Diet.
Mediterranean Diet Overview - Cleveland Clinic
Mediterranean diet: a heart-healthy eating plan - Mayo Clinic
Mediterranean Diet - The American Heart Association
Below are a list of resources, including recipes and tips for managing heart failure in your daily life:
Healthy Food Choices
© Copyright 2012, Meredith Corporation
Heart-Healthy Diet Recipes- Eating Well
Tips for Eating Out- American Heart Association
Butter vs. margarine: Which is better for my heart?-MayoClinic
Are chicken eggs good or bad for my cholesterol?
Lifestyle Changes
Following recommendations can help to alleviate symptoms, slow the progression of heart failure and improve everyday life. People with mild to moderate heart failure have the ability to lead normal lives as a result of diet, exercise and other healthful habits.
Lifestyle Changes for Heart Failure- American Heart Association
Living with CHF: A Guide for Family Caregivers
Exercise
As with any diet program, exercise is a crucial aspect of making healthy lifestyle changes. Traditionally, bed rest was recommended for individuals with CHF to avoid straining an already weak heart. However, in the past two decades, numerous studies have shown advantages from endurance exercise. The benefits of such studies appear to be the result of peripheral adaptations. One study in particular studied the effects of endurance exercise on morbidity and mortality associated with CHF- results demonstrated that an endurance training program lasting 14 weeks decreased hospitalizations 71% and deaths 68%.
Example of CHF Exercise Programming:
Increase peak work rate and endurance capacity
20-60 min/session or 2-3 sessions/day of 10-20 minutes
40-70% VO2max (i.e. brisk walking 4 mph to jogging 6 mph)
Return to work
Improve quality of life and maintain independence
Note: Highly skilled personal trainers or physical therapists should be monitoring CHF patients and checking vitals at all times, from start to finish.
More Exercise Informative Links:
Heart Failure Exercise/Activity Guidelines-Cleveland Clinic
Exercise and Activity with Heart Failure - Heart Failure Society of America
Recipes
As mentioned previously, food preparation is an effective way to implement dietary changes. The following recipes provide meal options for common dishes to facilitate the implementation of heart healthy diet modifications.
Featured Heart Healthy Recipes -American Heart AssociationGreat Heart Healthy Beef Recipes-American Heart Association
Poultry Recipes-American Heart Association
Pasta Recipes-NIH
DASH diet recipes-MayoClinic
Low Sodium Recipes- Food Network
Tools
My Life Check-American Heart Association/American Stroke Association
Fat & Sodium Explorer-American Heart Association
Frequently Asked Questions About Nutrition-American Heart Association
Videos
Watch the US Food and Drug Administration's Consumer Update on Heart Healthy Eating:
(https://www.youtube.com/watch?v=WFECS3JPQmc)
For more information on heart failure, visit the Heart Failure - General Information page.